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In a randomized trial of 187 adults with obesity, intermittent fasting combined with supervised exercise led to greater weight and body-fat loss over 12 weeks than standard care. Liver fat fell across all groups, but the study found no significant overall advantage for the interventions on that measure, and the weight and body-composition differences were no longer detectable one year later.
A 12-week randomized trial of 187 adults with obesity found that combining intermittent fasting and supervised exercise produced greater short-term weight and body-fat loss than standard care, while improving fitness. The intervention did not produce a statistically significant overall advantage in liver-fat reduction, and the differences in weight and body composition were no longer detectable one year after the program ended.
The TEMPUS study assigned participants to one of four groups: standard care, intermittent fasting, supervised exercise, or both fasting and exercise. All groups received education on the Mediterranean diet and physical activity. Participants assigned to fasting ate within an eight-hour window each day; the exercise program combined supervised strength training with high-intensity aerobic exercise. About half the participants were women.
After 12 weeks, both fasting groups had lost an average of about 2.2 kilograms more than the standard-care group. The combined fasting-and-exercise group also lost more body fat than the standard-care and exercise-only groups. Participants in both exercise groups improved cardiorespiratory fitness, a measure of how well the heart and lungs support physical activity.
The trial’s primary outcome was liver fat, measured by MRI. Liver fat decreased in all four groups, but the researchers found no statistically significant overall differences between standard care and the interventions, or among the three intervention groups. The findings were published in Nature Communications by researchers led by the University of Granada’s Joint University Institute for Sport and Health, in collaboration with Spanish biomedical research institutions and hospitals.
Weight Benefits Were Short-Lived
The results suggest that an eating-time restriction paired with structured exercise can add to short-term weight and body-fat loss in adults with obesity. The exercise findings also matter beyond the scale: improved cardiorespiratory fitness may be relevant to cardiovascular health, although the trial does not establish that the program prevents disease or improves long-term health outcomes.
The follow-up tempers the short-term results. One year after the program, the researchers found no remaining differences between groups in changes to weight or body composition. That means the study supports a short-term effect under the tested conditions, not lasting weight loss from a 12-week intervention. It also did not show an overall liver-fat advantage, the trial’s primary focus.
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How the TEMPUS Trial Was Designed
The study was part of the TEMPUS project and examined time-restricted eating alongside supervised exercise in adults with obesity. Random assignment to four groups allowed researchers to compare the combined approach with fasting or exercise alone and with standard care. The shared diet and activity education means the comparison was between those additional strategies on top of a common program, rather than between treatment and no guidance.
The researchers also examined outcomes by sex and among participants with fatty liver at the start. In men, the combined program was associated with a greater liver-fat reduction than standard care; that difference was not seen in women. Among participants who began with fatty liver, about 30% in the combined group no longer met the study’s diagnostic criteria after the program, compared with 6.5% receiving standard care. These subgroup findings do not replace the overall result, which showed no statistically significant difference in liver-fat changes between groups.
Long-Term Effects Remain Unclear
The trial does not establish whether a longer program, continued support, or a different maintenance strategy could preserve the short-term weight and body-fat changes. The available report also does not provide enough detail to determine how well participants adhered to the eating window and exercise schedule, or whether the results apply to people with different health profiles and levels of obesity.
The sex-specific and fatty-liver findings are subgroup results. The researchers cautioned that the sex analyses do not establish that the intervention works differently by sex. The reported 30% and 6.5% figures describe participants meeting the study’s criteria after treatment; they do not show that the program cured fatty liver or that the result will persist.
Longer Programs Need Study
The study authors said further research should examine longer-lasting interventions, especially for people with high liver-fat levels, and test ways to maintain benefits after a structured program ends. No later TEMPUS trial or follow-up milestone is specified in the report. Until more evidence is available, the published findings describe outcomes from this particular 12-week program and its one-year follow-up, not a guarantee of lasting results.
Key Questions
What did the trial find about weight loss?
Over 12 weeks, participants who fasted, with or without supervised exercise, lost an average of about 2.2 kilograms more than the standard-care group. The combined group also lost more body fat than standard care and exercise alone.
Did combining fasting and exercise reduce liver fat more?
Not across the full trial population. Liver fat decreased in all four groups, but the researchers found no statistically significant overall differences between the interventions and standard care.
Did the results last a year?
At the one-year follow-up after the program, the researchers found no differences between groups in changes to weight or body composition. The report also says there were no between-group differences in liver-fat changes at that point.
Does the study show the approach works differently for men and women?
No. The combined program was associated with a greater liver-fat reduction than standard care among men, but the study authors said these analyses alone do not establish different effects by sex.
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